1. Statin use was associated with a higher risk of cataract formation (OR 1.09; p=0.01). Length of statin use was associated with cataract formation, not dosage (OR 1.001; p<0.001).
2. Statin use is an independent predictor of cataract formation (OR 1.43; R2 = 0.52).
Evidence Rating Level: 2 (Good)
Study Rundown: This study demonstrates that statin use may increase a patient’s risk of developing cataract. By evaluating a large cohort of patients in the military health care system, they were able to demonstrate a significant, albeit subtle, increase in the risk of cataract formation when receiving statins. Statin use was found to be an independent predictor of cataractogenesis. Given the importance of cholesterol in the lens epithelium, statins could inhibit its synthesis, thereby increasing the risk of cataract. Strengths of the study include its large sample size and the various statistical analyses, including a propensity score-matched analysis, completed in order to eliminate all confounding variables between the two groups. Limitations include the fact that the visual impairment caused the cataract was not assessed; given the minimal (although significant) difference in odds ratio, the severity of cataract may have been approximately equal in both groups, but this was not analyzed in this study.
Relevant Reading: Recent statin use and cataract surgery
In-Depth [retrospective study]: Age-related cataracts are the most common cause of blindness in the world. Previous studies hypothesized that statin use would impair the aging process of the lens, thereby delaying cataract formation, while others suggested the opposite. In this study, records from the military health system were evaluated to identify two groups of patients aged 30-85, who were statin users and nonusers, between 2003 and 2010. Outcome measure was a diagnosis of cataract. A propensity score-matched cohort of statin users and non-users was created in order to eliminate confounding variables. After excluded patients were eliminated, a matched cohort of approximately 7,000 patients was evaluated. Statin use was associated with a higher risk of cataract formation (OR 1.09; p=0.01). In addition, the length of statin use was associated with cataract formation, not dosage (OR 1.001; p<0.001). Utilizing regression analysis, the researchers found statin use to be a predictor of cataract formation (OR 1.43; R2 = 0.52). These studies demonstrate that statin use may be associated with increased risk of cataract.
By Swarup Swaminathan and Andrew Bishara
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